EP0955024B1 - Jeu d'éléments intravaginaux et procédé de traitement d'un prolapsus des organes urogénitaux - Google Patents

Jeu d'éléments intravaginaux et procédé de traitement d'un prolapsus des organes urogénitaux Download PDF

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Publication number
EP0955024B1
EP0955024B1 EP99201409A EP99201409A EP0955024B1 EP 0955024 B1 EP0955024 B1 EP 0955024B1 EP 99201409 A EP99201409 A EP 99201409A EP 99201409 A EP99201409 A EP 99201409A EP 0955024 B1 EP0955024 B1 EP 0955024B1
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EP
European Patent Office
Prior art keywords
intravaginal
insert
corrective
ball
balls
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Expired - Lifetime
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EP99201409A
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German (de)
English (en)
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EP0955024A3 (fr
EP0955024A2 (fr
Inventor
Marian Adamkiewicz
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Adamed Sp zoo
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Adamed Sp zoo
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Priority to EP05010738A priority Critical patent/EP1588680B1/fr
Publication of EP0955024A2 publication Critical patent/EP0955024A2/fr
Publication of EP0955024A3 publication Critical patent/EP0955024A3/fr
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F6/00—Contraceptive devices; Pessaries; Applicators therefor
    • A61F6/06—Contraceptive devices; Pessaries; Applicators therefor for use by females
    • A61F6/08—Pessaries, i.e. devices worn in the vagina to support the uterus, remedy a malposition or prevent conception, e.g. combined with devices protecting against contagion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
    • A61B5/1076—Measuring physical dimensions, e.g. size of the entire body or parts thereof for measuring dimensions inside body cavities, e.g. using catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0004—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse
    • A61F2/0031—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra
    • A61F2/005—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra with pressure applied to urethra by an element placed in the vagina
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H21/00—Massage devices for cavities of the body, e.g. nose, ears and anus ; Vibration or percussion related aspects A61H23/00
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B23/00—Exercising apparatus specially adapted for particular parts of the body
    • A63B23/20—Exercising apparatus specially adapted for particular parts of the body for vaginal muscles or other sphincter-type muscles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/45—For evaluating or diagnosing the musculoskeletal system or teeth
    • A61B5/4519—Muscles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2240/00—Manufacturing or designing of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2240/001—Designing or manufacturing processes
    • A61F2240/008—Means for testing implantable prostheses
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S128/00—Surgery
    • Y10S128/25—Artificial sphincters and devices for controlling urinary incontinence

Definitions

  • the present invention relates to an intravaginal set, used in the case of prolapse of the urogenital organs and urinary stress incontinence, or in the period of intervals, when a therapeutic intravaginal insert for treatment of static disorders of the urogenital organs and urinary stress incontinence is not currently inserted.
  • Prolapse of the urogenital organs causes decrease in distance between the uterine cervix and the vaginal inlet, descent of the anterior wall of the vagina along with the urinary bladder and urethra (the cysto-urethral angle becomes more obtuse), and urethra dislocates outside an operation range of the intra-abdominal pressure.
  • the physical exercises may increase the efficiency of the cross-striated muscles only, i.e. muscles dependent an our own will, whereas the urogenital organs equilibrium is also maintained by independent-of-our-will smooth muscles, controlled by the autonomous nervous system. Smooth muscles build the urinary bladder, urethra, internal sphincter muscle of urethra, and muscles in uterine ligaments fixing uterus in its normal position.
  • a significant progress in the treatment of static disorders of the urogenital organs has been made by development of a therapeutic insert (the subject of Polish patent specification no RP 138406), consisting of a hollow ball with string attached freely outside the ball, and the smaller metal ball, placed freely inside.
  • This device generates mechanical impulses stimulating contractions of surrounding muscles, both smooth, and cross-striated.
  • a metal ball placed freely in the intravaginal therapeutic insert generates the mechanical impulses by hitting its cap as a result of the centre of gravity translocation while walking.
  • the mechanical impulse stimulates muscular contraction. Regular muscular exercise results in muscles hypertrophy and an increase in muscular force.
  • the therapeutic insert may be applied twice a day, over the period of about 30 minutes.
  • Prolonged application longer than 30 minutes leads to muscular overstrain and abdominal pain.
  • An application of the therapeutic insert every day over the period of 3 months leads to satisfactory therapeutic results in the treatment of minor prolapse of the urogenital organs (grade I), while in mere advanced cases (grades II, III, IV) no improvement was observed.
  • the reconstructive surgery is performed to restore the normal position of the urogenital organs.
  • the device prostheses may be applied to ensure a normal position of the urogenital organs.
  • intravaginal disc for support of lowered or prolapsed uterus.
  • This disc is applied in such manner, that its ring surrounds the uterine cervix, thus preventing the uterus prolapse by extension of vaginal wall in the area of the posterior vaginal fornix.
  • a disadvantage of this design consists in difficulties in application and removal, what makes its use impossible, when the therapeutic insert is not currently used. As the disc is placed in the upper part of the vagina, it does not transmit the contraction of the levator ani muscle, thus the uterus is not elevated.
  • the respective British patent application discloses a plastic planar arc, the wider arm of which rests an the pubic symphysis, while the second, narrow arm presses the urethra against the urinary bladder.
  • the maximal time for intravaginal application is 2 hours which limits the usefulness of this device in unlimited time.
  • Mode of action consists in local compression of the urethra, what may lead to inflammation and decubitus ulcers.
  • vaginal pack made in Germany
  • Its mode of action consists in mild compression of urethra and adjustment to the vagina after soaking with water before intravaginal application.
  • This vaginal pack does not meet the corrective functions, and may cause inflammatory state in the case of prolonged intravaginal presence. Soaking with vaginal secretion may result in distension of the vagina leading to progressive prolapse of the uterus and urinary bladder.
  • Applicant's corresponding US Patent No. 6,530,879 includes a recitation of prior art which fulfils the duty of candour on the part of Applicant towards the United States Patent and Trademark Office.
  • the list of prior publications include two papers by Morton et al which report on Applicant's own KOLPEXIN T (trademark) device that corresponds to the "therapeutic insert" described in the present specification. See US-A-4574791 for disclosure of a vaginal insert on a cable for training the pubo coccygeus muscle in a rhythmic contraction and relaxation that reciprocates the insert in the vaginal cavity.
  • the object of the present invention is to design an intravaginal set for a method of treatment to obtain permanent optimal position of the uterus and urinary bladder.
  • An intravaginal set according to the invention is useful in the case of prolapse of urogenital organs and urinary stress incontinence, or in the period of intervals in women when an intravaginal therapeutic insert for treatment of static disorders of the urogenital organs and urinary stress incontinence is not currently inserted, which therapeutic insert consists of hollow plastic ball with string attached and freely moving outside the ball, and with smaller ball, placed freely inside said hollow plastic ball, which smaller ball has a weight adequately adjusted to generate mechanical impulses stimulating alternate contractions of the smooth muscles, said intravaginal set comprising a sub-set of intravaginal corrective inserts and an intravaginal measuring sub-set for determining the size of the insert wherein the sub-set of intravaginal corrective inserts comprises at least two balls with step increase in diameter, ranging between the minimal and maximal woman vaginal diameter, each ball being
  • the invention enables a method of treatment of prolapse of urogenital organs and urinary stress incontinence or in the period of intervals in women when the intravaginal therapeutic insert for treatment of static disorders of the urogenital organs and urinary stress incontinence is not currently inserted, by selecting the appropriate size of corrective insert from the sub-set of intravaginal corrective inserts, said selecting being realised by means of the intravaginal measuring sub-set, by the selection of appropriate optimal diameter and depth of localization of the corrective insert in vagina by approximations with using the balls from the measuring subset, so that contraction of the levator ani muscle will cause the elevation of the insert and the elevation of the insert will cause the elevation of the uterus and/or correction of the cysto-urethral angle, and during the progress of said treatment the sizes of successive applied corrective inserts are adjusted by analogic selection of appropriate optimal diameter and depth of localization of the measuring ball in the vagina, and advantageously by carrying out the exercises of the pelvic floor muscles of treated woman lying in
  • the insert diameter selected by means of the measuring device, should ensure permanent correction of uterine and bladder placement, so that wall of the vagina was not too tense, and that a mass of lowered organs did not cause prolapse of the insert in the standing position.
  • the corrective insert from the set being the subject of the invention is used in the intervals between applications of the therapeutic insert and exerts beneficial effect on the muscles by removal of the isometric contraction and better preparation for dynamic contraction following application of the therapeutic insert.
  • An alternating application of the therapeutic insert and the corrective insert enables the treatment of the more advanced cases of the urogenital prolapse and improves results of the therapy up to 80%.
  • the corrective insert applied alternately with the therapeutic insert supports the uterus in its optimal placement and, due to its spherical shape, it may move and turn freely in different directions, thus preventing. decubital ulceration.
  • Fig. 1 shows a sub-set of the corrective intravaginal inserts from the set being the subject of the invention
  • Fig. 2 shows the measuring sub-set from the set being the subject of the invention
  • Fig. 3 is a simplified sagittal cross-section of the female pelvis with the cysto-urethral angle enlarged almost up to 180°, when the micturition is started under control or in an involuntary way
  • Fig. 1 shows a sub-set of the corrective intravaginal inserts from the set being the subject of the invention
  • Fig. 2 shows the measuring sub-set from the set being the subject of the invention
  • Fig. 3 is a simplified sagittal cross-section of the female pelvis with the cysto-urethral angle enlarged almost up to 180°, when the micturition is started under control or in an involuntary way
  • Fig. 1 shows a sub-set of the corrective intravaginal inserts from the set being the subject of the invention
  • Fig. 2 shows the measuring
  • Fig, 5 is also a sagittal cross-section of the female pelvis and is showing a method of measuring the diameter of the vagina for determination of optimal localization and size of the corrective insert.
  • the intravaginal set being the subject of the invention consists of the sub-set of corrective intravaginal inserts (Fig. 1) being preferably the hollow balls 1 with step increase in diameter, ranging between the minimal and maximal vaginal diameter.
  • Each ball 1 has the loosely hanging string 2 and is made preferably of medically inert plastics, such as polycarbonate or methyl methacrylate, and the set also consists of the intravaginal measuring sub-set (Fig. 2) containing measuring balls 3 made preferably of metal or plastic with graduated diameters corresponding to graduated diameters of balls 1 of the sub-set of corrective intravaginal inserts from Fig. 1; ,which balls 3 instead of the loosely hanging string 2 have, rigidly mounted, linearly scaled slat 4.
  • the slat 4 is preferably scaled for measurement of diameter and optimal localization of the corrective insert in the vagina in the case of urinary stress incontinence
  • Fig. 3 shows a simplified sagittal cross-section of the female pelvis with the cysto-urethral angle enlarged almost up to 180°, when the micturition is controlled or involuntary.
  • Fig. 5 shows the method of measuring diameter of the vagina using the ball 3 from the measuring sub-set for determination of depth of localization and size of the corrective insert.
  • the appropriate anatomical size is adjusted using the balls 3 from the measuring sub-set. After the adjustment, it is checked, whether the measuring insert is not pushed out by the descending organs. In this case, a greater insert diameter should be applied. In the case of urgency, the insert is placed too high, then a smaller insert should be applied.
  • the application of the corrective intravaginal insert consists in determination of optimal diameter of the insert and intravaginal application of the corrective intravaginal insert for an indefinite period of time.
  • Fig. 4 shows a sagittal cross-section of the female pelvis with the corrective insert with properly selected diameter of the ball 1 by means of the measuring sub-set, and the string 2 is used for removal of the insert.
  • Mode of action of the insert is as follows: the insert being placed in the vagina is supported on the levator ani muscle. It results in forward and upward shift of the lowered anterior wall of the vagina and elevation of the urethra and urinary bladder. An elevation of the urethra restores its normal position in relation to the posterior wall of the urinary bladder (reduced cysto-urethral angle shown an Fig. 4). In the case of concomitant uterine prolapse, the insert causes elevation of the uterus.
  • the device also enables a controlled micturition due to correction of the cysto-urethral angle a without the necessity to remove the insert for micturition.
  • Displacement of the uterus to the "pure zone" enables complete removal of inflammation. Relaxation of muscles and fasciae restores normal blood supply of the organs of the pelvis minor. It is most probable that the corrective insert improves results of the treatment with the therapeutic insert. Alternating application of the therapeutic insert and the corrective insert enables the treatment of the more advanced cases of the urogenital descent and improves results of the therapy.
  • the insert can be easily applied and removed. It is supported an the posterior wall of the vagina at level of the levator muscle of anus, thus it prevents excessive extension of the vaginal walls.
  • the corrective insert from the set being the subject of the invention supports the prolapsed uterus and blocks the urethra in the case of urinary stress incontinence, inadequate urethral occlusion at increased intra-abdominal pressure.
  • An optimal adjustment of insert diameter to the vagina allows the muscles to regenerate by reduction in uterine and cystic pressure.
  • the corrective insert supports these organs, and after regeneration, the muscles will support the uterus and urinary bladder again, but in a corrected position.
  • a method of the treatment of prolapse of the urogenital organs and urinary stress incontinence in women is enabled with usage of the intravaginal set.
  • the appropriate corrective insert is selected from the sub-set of corrective intravaginal inserts, consisting of at least two balls with step increase in diameter, ranging between the minimal and maximal vaginal diameter, each ball being preferably hollow, has the loosely hanging string and is made of medical material, such as polycarbonate or methyl methacrylate, and consisting of the intravaginal measuring sub-set that contains at least two metal or plastic balls with diameters corresponding to the diameters of the balls from corrective intravaginal sub-set which instead of the loosely hanging string, have, rigidly mounted, scaled slat for measurement of optimal diameter and localization of the insert in the vagina, depending on individual anatomical conditions of urogenital organ in woman, by selection of appropriate diameter and depth of vaginal localization by means of approximations with meaning balls from the measuring sub-set, so that
  • Size of the applied insert gradually decreased under medical supervision using the measuring device and ensures permanent correction of uterine and bladder placement by correction of the cysto-urethral angle a, so that the muscle fibres diffused in surrounding tissue may restore the lowered organs to primary placement.
  • the uterus In the case of significant urogenital prolapse, the uterus is at the same level as the arms of the levator ani muscle, increasing distance between them.
  • an exercise of the levator ani muscle is disadvantageous, because muscular contraction exerts pressure on the descendent uterus without concomitant elevation.
  • the corrective intravaginal insert causes an elevation of the uterus, while contractions of the levator ani muscle elevates the insert and, indirectly, the uterus.
  • the corrective insert may fall out at muscular contraction, when its diameter is too small. It is beneficial to make the test for contraction of the levator ani muscle following an adjustment of the corrective insert by the measuring device.
  • the measuring device for examination of so-called pelvic floor thickness, i.e. following application, the measuring device is slightly pulled downward to rest it on the arms of the levator ani muscle and the distance from the pubic symphysis is read from the scaled slat.
  • An assessment of therapeutic effect includes repeated measurements of optimal diameter of the corrective insert.

Claims (5)

  1. Ensemble de traitement intravaginal, utile dans le cas d'un prolapsus d'organes urogénitaux et d'incontinence d'urine à l'effort, ou lors de la période des intervalles chez la femme où un élément d'insertion thérapeutique intravaginal pour le traitement de troubles statiques d'organes urogénitaux et d'incontinence d'urine à l'effort n'est pas effectivement inséré, lequel élément d'insertion thérapeutique est constitué d'une bille en matière plastique creuse comportant un cordon fixé et se déplaçant librement à l'extérieur de la bille, et avec une bille plus petite, placée librement à l'intérieur de ladite bille en matière plastique creuse, laquelle bille plus petite présente un poids ajusté de façon adéquate pour générer des impulsions mécaniques stimulant des contractions alternées des muscles lisses, ledit ensemble de traitement comprenant un sous-ensemble d'éléments d'insertion correcteurs intravaginaux en vue d'une élévation de l'utérus et un autre sous-ensemble d'éléments d'insertion de mesure intravaginaux destiné à déterminer une taille optimale pour l'élément d'insertion correcteur, où le sous-ensemble d'éléments d'insertion correcteurs intravaginaux comprend au moins deux billes correctrices (1) présentant une augmentation de diamètre par étape, se situant entre le diamètre minimal et maximal du vagin de la femme, chaque dite bille correctrice comportant un cordon pendant librement (2) destiné à le retirer du vagin, tandis que le sous-ensemble de mesure intravaginal comprend au moins deux billes (3) ayant des diamètres progressifs correspondant aux diamètres progressifs des billes (1) du sous-ensemble d'éléments d'insertion correcteurs intravaginaux, lesquelles billes de mesure (3) à la place du moyen de retrait (2), comportent une lamelle (4) montée de façon rigide sur chaque bille (3) du sous-ensemble de mesure en vue de la mesure du diamètre et de la profondeur d'emplacement de l'élément d'insertion correcteur dans le vagin, en fonction des conditions anatomiques réelles et individuelles des organes urogénitaux de la femme qui est traitée, qui est optimal pour l'élévation de l'utérus.
  2. Ensemble intravaginal selon la revendication 1, caractérisé en ce que, chaque bille (1) du sous-ensemble d'éléments d'insertion correcteurs est creuse.
  3. Ensemble intravaginal selon l'une quelconque des revendications précédentes, caractérisé en ce que, chaque bille (1) du sous-ensemble d'éléments d'insertion correcteurs est réalisée à partir d'une matière médicale qui est un polycarbonate ou un méthacrylate de méthyle.
  4. Ensemble intravaginal selon l'une quelconque des revendications précédentes, caractérisé en ce que, chaque bille (3) du sous-ensemble de mesure est constituée de métal ou de matière plastique.
  5. Ensemble intravaginal selon la revendication 6, caractérisé en ce que, la lamelle (4) comporte une échelle de mesure linéaire.
EP99201409A 1998-05-04 1999-05-04 Jeu d'éléments intravaginaux et procédé de traitement d'un prolapsus des organes urogénitaux Expired - Lifetime EP0955024B1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP05010738A EP1588680B1 (fr) 1998-05-04 1999-05-04 Jeu d'éléments intravaginaux

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
PL98326141A PL186960B1 (pl) 1998-05-04 1998-05-04 Zestaw dopochwowy
PL32614198 1998-05-04

Related Child Applications (1)

Application Number Title Priority Date Filing Date
EP05010738A Division EP1588680B1 (fr) 1998-05-04 1999-05-04 Jeu d'éléments intravaginaux

Publications (3)

Publication Number Publication Date
EP0955024A2 EP0955024A2 (fr) 1999-11-10
EP0955024A3 EP0955024A3 (fr) 2002-02-06
EP0955024B1 true EP0955024B1 (fr) 2005-09-07

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EP05010738A Expired - Lifetime EP1588680B1 (fr) 1998-05-04 1999-05-04 Jeu d'éléments intravaginaux
EP99201409A Expired - Lifetime EP0955024B1 (fr) 1998-05-04 1999-05-04 Jeu d'éléments intravaginaux et procédé de traitement d'un prolapsus des organes urogénitaux

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EP05010738A Expired - Lifetime EP1588680B1 (fr) 1998-05-04 1999-05-04 Jeu d'éléments intravaginaux

Country Status (11)

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US (1) US6530879B1 (fr)
EP (2) EP1588680B1 (fr)
CN (1) CN1264484C (fr)
AT (1) ATE303775T1 (fr)
CA (1) CA2270460C (fr)
DE (2) DE69927085T2 (fr)
DK (2) DK0955024T3 (fr)
ES (2) ES2247756T3 (fr)
HK (1) HK1024160A1 (fr)
PL (1) PL186960B1 (fr)
PT (2) PT1588680E (fr)

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US7717892B2 (en) 2006-07-10 2010-05-18 Mcneil-Ppc, Inc. Method of treating urinary incontinence
US7824701B2 (en) 2002-10-18 2010-11-02 Ethicon, Inc. Biocompatible scaffold for ligament or tendon repair
US7875296B2 (en) 2003-11-26 2011-01-25 Depuy Mitek, Inc. Conformable tissue repair implant capable of injection delivery
US7901461B2 (en) 2003-12-05 2011-03-08 Ethicon, Inc. Viable tissue repair implants and methods of use
US8137686B2 (en) 2004-04-20 2012-03-20 Depuy Mitek, Inc. Nonwoven tissue scaffold
US8221780B2 (en) 2004-04-20 2012-07-17 Depuy Mitek, Inc. Nonwoven tissue scaffold
US8226715B2 (en) 2003-06-30 2012-07-24 Depuy Mitek, Inc. Scaffold for connective tissue repair
US8389588B2 (en) 2003-12-04 2013-03-05 Kensey Nash Corporation Bi-phasic compressed porous reinforcement materials suitable for implant
US8445554B2 (en) 2004-04-29 2013-05-21 Kensey Nash Corporation Compressed porous materials suitable for implant
US8449561B2 (en) 1999-07-23 2013-05-28 Depuy Mitek, Llc Graft fixation device combination
US8608639B2 (en) 2006-07-10 2013-12-17 Mcneil-Ppc, Inc. Resilient device
US8617047B2 (en) 2005-03-17 2013-12-31 Contipi Ltd. Apparatuses for the amelioration of urinary incontinence in females
US8651109B2 (en) 2008-04-23 2014-02-18 Contipi Ltd. Pessaries for prolapse alleviation
US8657881B2 (en) 2004-04-20 2014-02-25 Depuy Mitek, Llc Meniscal repair scaffold
US8691259B2 (en) 2000-12-21 2014-04-08 Depuy Mitek, Llc Reinforced foam implants with enhanced integrity for soft tissue repair and regeneration
US8727961B2 (en) 2003-05-22 2014-05-20 Kimberly-Clark Worldwide, Inc. Apparatus for the prevention of urinary incontinence in females
US8753258B2 (en) 2006-07-10 2014-06-17 Mcneil-Ppc, Inc. Resilient device
US8895045B2 (en) 2003-03-07 2014-11-25 Depuy Mitek, Llc Method of preparation of bioabsorbable porous reinforced tissue implants and implants thereof
US8911345B2 (en) 2006-07-16 2014-12-16 Kimberly-Clark Worldwide, Inc. Apparatuses for the amelioration of urinary incontinence in females
US9198748B2 (en) 2007-06-11 2015-12-01 Contipi Medical Ltd. Adjustable tension ring for amelioration of urinary incontinence in females
US9339363B2 (en) 2007-10-01 2016-05-17 Kimberly Clark Worldwide, Inc. Management of urinary incontinence in females
US9511171B2 (en) 2002-10-18 2016-12-06 Depuy Mitek, Llc Biocompatible scaffolds with tissue fragments

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EP0955024A3 (fr) 2002-02-06
PT955024E (pt) 2005-11-30
DE69937654D1 (de) 2008-01-10
CN1264484C (zh) 2006-07-19
EP1588680B1 (fr) 2007-11-28
PL326141A1 (en) 1999-11-08
CN1238170A (zh) 1999-12-15
DE69927085D1 (de) 2005-10-13
EP1588680A1 (fr) 2005-10-26
DE69927085T2 (de) 2006-06-29
DE69937654T2 (de) 2008-10-30
HK1024160A1 (en) 2000-10-05
ES2297564T3 (es) 2008-05-01
ATE303775T1 (de) 2005-09-15
EP0955024A2 (fr) 1999-11-10
DK0955024T3 (da) 2005-10-17
CA2270460A1 (fr) 1999-11-04
CA2270460C (fr) 2006-11-28
PL186960B1 (pl) 2004-04-30
US6530879B1 (en) 2003-03-11
PT1588680E (pt) 2007-12-18
ES2247756T3 (es) 2006-03-01
DK1588680T3 (da) 2008-01-28

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